NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE. HME� CASE 4: <br />I—Ite . . . . . ............................ . <br />.......... A—: <br />L.,0CATION (PARK/OPEN SPA(",E): <br />F- Name' Lasl 'ddle DO, <br />Jy. <br />-4city State Zip Res. Pfione: Work Phune� <br />04 — <br />— TKAK) <br />tinder the authority of Administrative Order No. 58-03-24-F and Park and Open Space Rule 114.005(3), you are hereby <br />notified that you are prohibited from (check box): <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />.................................. . . ....... . .................... . . . ..... . . . . . . . . . . . ....................................................................... . . . . . . ... <br />�c, <br />of1he P.ark, <br />The basis for this Noti ce o f Restriction ofUse is, that on — . .......... ..... .. . you violated Setr�,tion <br />and Open Space Rules, anctlor Section . . .... of the Eugene Code, 197 1, and/or ORS ... .... .. . -r-0 wit, <br />t-�k (:-H <br />..................... , <br />............... ---- . ................ . . . . . . ......... . . <br />(Description of the violation.) <br />r <br />This restriction of use is effective beginning on and shall remain in effect until . ....... . ...... ...................... . . . <br />ff you enter in or use any City of'Eugene park,, open space or facility during the effective period of this Noticc,.You. may be <br />arrested and charged with critninal trespass in the second degree. <br />Pursuant to Park and Open Space Rule fl. -1 074 you are entitled to an informal hearing to contest this Notice. A reqUCS1, KIT,111 <br />informal hearing must be made in writing and filed with the Parks & Open Space Division Dircoor ("the Division Director") <br />within 48 hour,,, (cx cl us i v e of'weekends) of'reccipt ofth is Notice at the fol low ing address 1820 Roosevelt, Blvd., Eugen e, OR <br />97402. <br />The Division Director shall schedule a time and place f6r the informal hearing to be conducted, which shall be not more flian <br />72 hours (exclusive of weekends) of receipt of the request for hearing, At the inf6rrnal hearing the Division Director Neill only <br />consider testimony ftorn you, ("Jty personnel, involved in the incident that resulted in this Notice, and otherwitnes'ses to the <br />inciderit- The Divisiim Director may exclude anyone, other than you and those presenting testiniony', from the informal hcan' ng, <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice of Exclusion was delivered. to the person named at the top of this Notice at the date and time shown above by. <br />T F, ...................... ........................ . . . ..... <br />. . . ............. . <br />(Signature (if person issuing/delivOring notice) <br />I hereby acknowledge receipt of the above Notice on. the date and time indicated above, <br />1��.A� C, 1 U <br />. ....... .............................. . . . . . . . . . . . . ................................. <br />(Sigypature of'per.;oin being issim.�.d the notice) <br />A'h' e (.'upyPu blk Wnrkq (3ri.-en Copy' Filc Yudliow Copy� Repad Cupy Nnk ( opy: Recipieril Ciold Copy Officer vyfirne kv,, 04103 <br />